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Department of Health to investigate whether incentives should be offered for good scores in metrics

2 December, 2008

The Department of Health will consider whether financial incentives should be offered for achieving good scores in the new set of nursing quality measures or metrics – currently under development.

‘It’s something that we have talked about. I’d like to see it in action before taking any next steps,’ said David Foster, deputy chief nursing officer for England, in his first interview with Nursing Times since taking up office last week.

He said he had been invited to inspect an incentive project being pioneered since October by the North West strategic health authority (see box) as Nursing Times reported.

The North West SHA advancing quality project:

The pioneering system went live on 1 October across five hospitals in the SHA. It incentivises improvement across three quality indicator areas – clinical outcomes, patients reported outcome measures (whether patients’ quality of life has improved following surgery) and patient experience (patients’ own experience of the care provided)

These indicators deal with five common conditions and procedures – myocardial infarction, pneumonia, heart failure, hip and knee replacements, and heart bypass surgery

But Mr Foster said he was currently unsure about where boundaries between teams should be drawn under sucha system.

‘What I wouldn’t want to see is a system that focuses on a few clinical staff who get the benefit and others don’t,’ he said. ‘I’m looking at models but with some caution and I’d like to see it in action and how well it’s working.’

Mr Foster also acknowledged concerns highlighted by the survey over potential increases in paperwork created by metrics and how objectively they would be measured.

‘I recognise those sorts of fears,’ he said. ‘What I want quality metrics in nursing to be is a tool to improve practice, to implement change, to innovate new ideas. I don’t want it to be a management tool for people to be beaten up by.’

Mr Foster also said there is unlikely to be one national method set out for collecting metrics. ‘It’s people’s local circumstances that are really important. We’ll just give them the tools and the framework,’ he said.

‘I think what will engage nurses an awful lot is that their practice will enable them to exercise their leadership role and bring about change. It really is quite an exciting development if people aren’t fearful of it but can actually run with the benefits,’ he added.